Treating the human bladder with capsaicin: is it safe?
OBJECTIVE
Although human contact with capsaicin has occurred over thousands of years, some uncertainty surrounds its status as a possible carcinogen. This is the first report of bladder biopsies from patients who have been treated with capsaicin over a 5-year period.


METHODS
Between 1991 and 1996, 20 patients (9 males, 11 females; mean age 52.5 years, range 40-70 years) with intractable detrusor hyperreflexia have had repeated instillations of intravesical capsaicin (1-2 mmol/l). The number of treatments per patient varied between 1 and 17 (total = 82; average 6/patient). The surveillance programme involved repeated flexible cystoscopy and bladder biopsies before and after capsaicin. Cryostat sections were stained with haematoxylin-eosin and examined by light microscopy.


RESULTS
None of the bladder biopsies have shown metaplasia, dysplasia, flat carcinoma in situ, papillary or solid invasive cancer.


CONCLUSIONS
No pre-malignant of malignant change has been found in biopsies of patients who had repeated capsaicin instillations for up to 5 years. However, as the morphological effects of chemical carcinogens may not be apparent for 10 years, further surveillance is being continued.
Dasgupta
P
P
Uro-Neurology Department, Institute of Neurology, UCL Hospitals Trust, London, UK.
Chandiramani
V
V
Parkinson
M C
MC
Beckett
A
A
Fowler
C J
CJ
D000328:Adult; D000368:Aged; D001706:Biopsy; D002211:Capsaicin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D003558:Cystoscopy; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000188:drug therapy; D009188:Myelitis, Transverse / Q000150:complications / Q000188:drug therapy; D010148:Intractable Pain / Q000188:drug therapy* / Q000209:etiology; D010291:Paresis / Q000150:complications / Q000188:drug therapy; D013119:Spinal Cord Injuries / Q000150:complications / Q000188:drug therapy; D001743:Urinary Bladder / Q000187:drug effects* / Q000473:pathology; D001745:Urinary Bladder Diseases / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy
D002211:Capsaicin